How to Manage Viral Reactivation: Epstein-Barr, CMV + More

Though we tend to think about viruses only when sniffles or a cough slow us down, they are much more a part of everyday life than many would ever imagine. Viruses are ubiquitous in nature and infect every living organism.

In fact, your cells and all the bacterial cells in your body that make up your microbiome play host to an enormous variety of different viruses. Fortunately, the vast majority of the viruses that inhabit your body are a beneficial part of your microbial makeup.

There are exceptions, however. Beyond common colds and flus that come and go throughout your lifetime, you — and everyone else on the planet — contract potentially dangerous viruses that take up permanent residence in your body. And while they typically don’t cause severe illness or acute infections and instead stay dormant in tissues, if your immune system functions become depressed, these viruses can reactivate and cause chronic illness.

I call viruses and other microbes with these unique hide-and-revive characteristics “stealth microbes,” and being aware of which viruses can reactivate, how they affect your health and contribute to chronic illness, and what factors precipitate reactivation can help you stay one step ahead of any symptoms that might pop up. Here’s what you need to know about stealth viruses.

Viral Basics

Viruses are the simplest of all biological lifeforms. They’re so simple, in fact, that it’s debatable as to whether they’re even alive, and currently, no one has the absolute answer to this debate.

Unlike bacteria, which display metabolism, growth, and the ability to reproduce spontaneously, viruses consist solely of a segment of genetic material (either RNA or DNA) encased in a protein shell. They float around in an inactive or dormant state until coming into contact with a compatible living cell, at which point the virus enters the cell and attaches its protein shell to the cell’s outer membrane. Then, it injects genetic material, which takes over the host cell’s internal machinery, causing it to replicate with the infiltrator’s RNA or DNA and generate new viruses.

That compatibility between virus and living cell is key: Each type of virus can only infect specific cell types. But because the vast majority of viruses never reach their intended target, they instead accumulate in the environment. Which means viruses are present in the air you breathe, every surface you touch, and everything you eat or drink — billions of them.

Over a lifetime, you’re exposed to a nearly infinite number of viruses. Fortunately, most of them are totally harmless — they aren’t specific for humans and therefore can’t infect your cells. You do, however, have a multitude of viruses that are continually active in your body. They’re part of your microbial menagerie we call the microbiome.

Though you primarily hear about the bacteria in regards to your microbiome, it’s loaded with viruses, too. In reality, there is more viral activity in your body than bacterial activity. Though science is still working out the complexities of viruses, it’s assumed that with the amount of viral activity going on inside a healthy body, most of it must be beneficial.

Take a bacteriophage, for instance, which is a virus that only infects bacteria. Bacteriophages strongly influence the balance of bacteria in your gut, on your skin, and throughout your body by attacking and killing pathogenic bacteria. Scientists are learning to take advantage of this trait by developing strains of bacteriophages for treating bacterial infections, according to a review in the Journal of Infection in Developing Countries (JIDC). Because viruses are very specific in the types of bacteria they can infect, bacteriophages can be used to target certain threatening microbes without disrupting the balance of other microbes in the body.

Viruses As Stealth Microbes

Though most viruses that inhabit your microbiome aren’t problematic, there are always outliers — ones that can reactivate with the potential to cause chronic illness. But they only do so if the immune system falters due to factors such as infections, environmental toxins, and stress.

Symptoms of viral reactivation are highly variable and include fatigue, flu-like symptoms, brain fog, muscle aches, disturbed sleep, irritability, and stress intolerance. In other words, all the same symptoms shared by fibromyalgia, chronic fatigue syndrome, chronic Lyme disease, and a range of other chronic illnesses.

The group of stealth microbes that can affect how you feel and impact your health includes bacteria, viruses, protozoa, and fungi. Over the years, I’ve compiled a list of more than a hundred known microbes that can be considered stealth, and there are likely many more yet to be recognized.

The known stealth viruses commonly associated with fatigue-like syndromes include:

Of those possibilities, the viruses most apt to cause symptomatic reactivation are the herpes class of viruses, which includes EBV, CMV, HSV-1, HSV-2, HZV, and the different forms of HHV.

The Top 5 Stealth Viruses to Watch Out For

When you’re struggling with symptoms of fatigue, poor sleep, brain fog, and irritability, it’s natural to want to know exactly which virus is causing the problem. Therein lies the rub: Unlike the initial infection, reactivation of a stealth microbe doesn’t occur in isolation — usually, various microbes re-emerge at the same time. And because every person carries a different spectrum of stealth microbes, reactivation syndromes are slightly different for every person.

That being said, understanding the particularities of some of the more common culprits can provide you with clues as to what’s making you feel crummy, and aid you on your road to recovery.

1. Epstein-Barr Virus

EBV, a double-stranded DNA virus in the herpes family, is one of the most common viruses associated with illness in humans. A large portion of the population is exposed to EBV at an early age. By adulthood, 95% of the population has been exposed. The virus is shed in saliva, giving it the nickname “the kissing disease.”

People exposed to EBV during childhood generally experience mild symptoms or none at all. It’s only people who are first exposed to EBV during adulthood who develop mononucleosis, a more severe illness typified by profound fatigue, chronic sore throat, low-grade fever, lymph node swelling, headache, and an enlarged spleen. The syndrome gradually resolves, but the fatigue associated with it can drag on for months or even years.

Once the initial infection with EBV resolves — whether during childhood or adulthood — the virus stays dormant in salivary glands and other lymphoid tissue. Any lapse in immune function can allow the reactivation of the virus.

The predominant symptoms associated with relapse are fatigue and feeling flu-like. Reactivation symptoms can wax and wane over many years. Though mononucleosis, the primary EBV infection, responds to various antiviral drugs, chronic EBV infection does not.

2. Cytomegalovirus

Like EBV, CMV is a double-stranded DNA virus in the herpes family, and it is very prevalent — 90% of the general population has been infected with CMV at some point. The initial infection can resemble mononucleosis and include fever, feeling flu-like, swollen lymph glands, headache, and an enlarged spleen. However, most people may never realize they’ve acquired the virus; they’ll have minimal or no reactions at all.

After the initial infection, CMV remains dormant in fibroblasts and other immune cells of the spleen, liver, and other tissues in the body unless immune function falters and there’s an opportunity to reactivate. The viral reactivation symptoms are similar to those of EBV, and primarily include fatigue and feeling flu-like. Like EBV, chronic CMV typically does not respond to antiviral drug therapy.

The greatest concern with CMV is its association with cardiovascular illness. While this is relatively uncommon, a study published in the Journal of the American Heart Association suggested that cardiovascular disease attributable to CMV could be as high as 13.4%. But it’s important to note that the study examined only that one microbe — odds are that additional stealth organisms were at play, too, just as they are in other chronic illnesses.

3. Human Herpes Viruses (Roseolovirus)

Several closely-related herpes-type viruses — HHV-6a, HHV-6b, and HHV-7 — cause a mild, transient childhood illness characterized by a rash, which generally occurs on the extremities. By age 2, most children have been infected via entry into the respiratory tract. After the initial infection, the virus remains dormant in the body. Reactivation can occur when immune function is compromised. The main reactivation symptom is fatigue, but compared to other viruses, it’s often milder.

4. Herpes Simplex Virus (HSV-1 and HSV- 2)

These are the classic viruses that most people know as herpes. Generally, HSV-1 is associated with fever blisters (cold sores around the lips), and HSV-2 is associated with genital herpes, but both viruses can occur at either location.

Initial infection with HSV-1 or HSV-2 is characterized by painful ulcers and a flu-like syndrome with swollen lymph nodes, fever, muscle aches, headache, and fatigue. After the initial infection, the virus takes up residence in nerve tissues.

A reactivation is associated with a painful localized ulcer and sometimes mild fatigue. Typically, HSV does not play a major role in chronic fatigue-like syndromes. Both an acute infection and reactivation can be treated with antiviral drug therapies like acyclovir or valacyclovir.

5. Herpes Zoster Virus

Also known as Varicella Zoster Virus, HZV is another double-stranded DNA, herpes-type virus, but this one is the cause of childhood chickenpox. Chickenpox can be a serious illness with severe ulcerative lesions all over the body. Like the herpes simplex virus, HZV remains dormant in nerve tissue after the initial infection.

When HZV reactivates, it’s called shingles. It occurs along a specific dermatome, an area of the skin that’s innervated by one nerve tract originating from the spinal cord. Shingles is localized to one side of the body, but it can occur in any dermatome. The lesions are extremely painful and are accompanied by severe fatigue and body aches.

Acute illness like chicken pox can be treated with antiviral drug therapy, including acyclovir and valacyclovir. Also, HZV vaccinations in children prevent both chickenpox and shingles. In adults, vaccinations can prevent shingles, but the immune system must be healthy for the vaccine to take effect.

Should You Test for Stealth Viruses?

It’s human nature to want to identify any problematic pathogens that are making you sick so that you can be properly treated. Unfortunately, the answer as to which microbes are making you sick isn’t always a simple one.

A chronic infection with any microbe, whether it’s viral, bacterial, protozoan, or fungal, is directly related to how well your immune system operates. If your body’s disease-fighting network experiences a disruption, microbes have the opportunity to reactivate. Any and all of the viruses discussed above, along with a variety of other microbes, can flourish and cause symptoms. Therefore, it’s unlikely you’ll be able to pin down a specific microbe that’s responsible for your chronic symptoms.

That being said, if your doctor offers testing for different microbe possibilities, you may choose to have it done. Testing can be helpful to differentiate between an acute viral infection or a chronic reactivation. But if you’re an adult with chronic, persistent symptoms like fatigue, muscle pain, or a general flu-like feeling, you can count on it being a chronic reactivation, which usually doesn’t respond well to antiviral, drug therapy.

If you decide not to test, however, you can still get better. The good news is that in all my years of working with patients, lack of testing has rarely been a hindrance to treating and recovering from chronic Lyme disease or fibromyalgia. I’ve discovered that starting with a recovery program that includes safe, comprehensive herbal therapy is likely to address the full spectrum of stealth microbes that might be at play.

After all, if your recovery progresses (and it usually does), the expense of testing is probably not necessary for you to get well. In the end, testing may be most beneficial to people who have lingering, problematic symptoms that don’t improve with a comprehensive herbal therapy program.

Solutions for Viral Reactivation

At first glance, the lineup of stealth viruses may seem like an overwhelming list of problems to address. But recovery from viral reactivation syndromes requires recognizing that the driving force behind the problem is singular: chronic immune dysfunction.

Remember, viruses and other stealth microbes only become active and trigger symptomatic illness if the immune system becomes compromised; otherwise, they remain silent. And the good news is that natural therapies and lifestyle modifications can benefit you no matter which virus or combination of viruses reactivates.

To regain wellness, your ultimate goal is long-term suppression of microbes so that your immune system can rebound and keep those pesky viruses under control. For suppressing microbes and restoring normal immune system functions, herbal therapy provides a promising approach to managing viral reactivation. My antiviral herbs of choice include:

Because there are often many different kinds of microbes in the mix that contribute to illness, I like the fact that these herbs also offer a broad range of antimicrobial properties against bacteria, protozoa, and fungi. In addition, they bolster your immune system, another essential component of recovery.

Of course, restoration of the immune system also requires addressing the underlying causes of chronic immune dysfunction. There are always precipitating factors for reactivation of microbes. Sometimes, it’s a stressful event such as extreme emotional or physical trauma, but often, it’s chronic stress that adds up over time.

The factors that can trigger reactivation can be divided into five different categories — I call them System Disruptors. Minimizing each of these disruptors helps accelerate recovery beyond the benefits of herbs alone.

System Disruptor #1: An Unnatural, Modern Diet

In our fast-paced, fast-food world, it’s easy to reach for a bag of chips and a soda when we’re craving a snack — they’re tasty, cheap, and don’t require the prep time of, say, chopping up fresh veggies for dipping in hummus. But eating highly processed and packaged foods on a regular basis leaves your body devoid of the vital nutrients it needs to recover, and interferes with all systems of the body.

Natural Solution: Shop the perimeter of the grocery store where the freshest, most nutrient-dense items are on display, and avoid the central aisles, which are lined with boxed and packaged stuff. Then fill your cart with things like organic meats, vegetables, healthy fats, and low-sugar fruits for the most healthful diet.

System Disruptor #2: Toxins in Your Environment

Hidden toxins, toxicants (byproducts from the plastic, petroleum, and coal industries), and artificial energy from electronic devices can all suppress immune system functions and cause systemic inflammation. Another primary source of
environmental toxins in today’s world: mold. Approximately 50% of homes have problems with some type of indoor mold. When inhaled, mold spores and mycotoxins can assault the immune symptom, contribute to immune suppression, and pave the path for viruses and other microbes to thrive.

Natural Solution: Minimize your exposure to environmental toxins as much as possible: choose glass jars over plastic ones, filter your water and air, don’t sleep with your phone by your bedside, and do tech detoxes whenever possible. Also, be vigilant about hidden sources of moisture or mold in your home, and clean them up as soon as possible to maintain a clean environment.

System Disruptor #3: Chronic Stress

Ongoing stress (from financial difficulties, relationship woes, workplace strife) is a common cause of viral reactivation. It’s rampant in our society, and it has a significant impact on the immune system’s ability to ward off stealth microbes.

Natural Solution: If you’re experiencing a flare-up of viruses, consider what measures you are taking for healthful stress management. Are you prioritizing your sleep and adhering to a regular sleep schedule? Are you saying “no” to excessive responsibilities at work? Are you limiting the time you spend with people who make you feel stressed out? If the answer to these questions is no, or they call to mind other continuous sources of stress in your life, it’s time to take action and lessen or remove those things in your life that continuously cause you angst.

System Disruptor #4: Low Activity Levels

Over time, a sedentary lifestyle can lead to reduced circulation, decreased ability to expel toxins from your body, a downturn in your immune function, and worsening levels of fatigue.

Natural Solution: Initially, if you’re experiencing a viral reactivation, you may not feel up to the challenge of increasing your activity level; sometimes, you may need to rest until you begin to recover. However, you don’t need to push yourself to max capacity to experience the therapeutic benefits of movement. Low-impact, restorative exercise, like yoga, Pilates, a leisurely walk, or qigong can provide the gentle boost you need to foster an active lifestyle and beat viral reactivation — without overdoing it.

System Disruptor #5: A Microbiome Imbalance

A microbiome imbalance adds to a dysfunctional immune system, giving stealth pathogens the ability to increase, which can cause an onslaught of new or worsening symptoms.

Natural Solution: To mitigate the symptoms associated with viral reactivation, consider using an herbal approach to balancing your microbiome. Taking the right herbs allows you to suppress the bad microorganisms without annihilating the beneficial flora in your gut. In addition to the antiviral herbs discussed above, other herbs that are up to this task include:

Additionally, to make the most of your recovery protocol, be sure to allow yourself time for a good night’s sleep. An average of eight hours each night can reduce inflammation, improve your energy, and support your immune system.

Thankfully, in most cases, a restorative approach to keeping your immune system humming and managing viral reactivation will be sufficient for you to recover, though bear in mind it may take some time. But with patience, persistence, daily herbal therapy, and adopting a more healthful lifestyle, you’ll have the tools you need to restore your health and vitality and begin feeling better again soon.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.

After graduating from medical school, Dr. Bill Rawls practiced conventional medicine for 15 years. However, when Lyme disease and fibromyalgia disrupted his career at age 45, he was forced into the world of herbal and alternative medicine. He has since restored his health—and has a passion to help others do the same.
Read his story »